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12 Aug 2019
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11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
25 Jul 2019
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Prophylactic methylprednisolone may benefit some neonates undergoing cardiac surgery

11 Aug 2019

Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.

However, patients undergoing palliative procedures seem to benefit from corticosteroid therapy. In addition, a significant interaction exists between treatment effect and centre, suggesting the possibility of centre or patient characteristics that make prophylactic methylprednisolone helpful.

This double-blind randomized controlled trial determined whether intraoperative methylprednisolone improved postoperative recovery in neonate undergoing cardiac surgery. The investigators enrolled 190 neonates undergoing cardiopulmonary bypass at two centres after the induction of anaesthesia, among whom 176 (n=81 methylprednisolone 30 mg/kg; n=95 placebo) were included in the analysis.

The primary endpoint was a previously validated morbidity-mortality composite of any of the following events after surgery before discharge: death, cardiac arrest, hepatic injury, renal injury, mechanical circulatory support or rising lactate level (>5 mmol/l).

These outcomes occurred in 27 (33 percent) neonates in the methylprednisolone group and 40 (42 percent) in the placebo group (odds ratio [OR], 0.63, 95 percent CI, 0.31–1.3; p=0.21). However, methylprednisolone led to decreases in vasoactive inotropic requirement and in the incidence of the composite endpoint in patients undergoing palliative operations (OR, 0.38, 0.15–0.99; p=0.048).

Furthermore, a significant interaction was observed between treatment effect and centre in this analysis. Corticosteroid therapy conferred a protective benefit at one centre (OR, 0.35, 0.15–0.84; p=0.02) but not at the other (OR, 5.13, 0.85–30.90; p=0.07).

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Most Read Articles
12 Aug 2019
Treatment with nebivolol yields more favourable changes in 24-hour, intradialytic and daytime systolic and diastolic blood pressure variability in patients with intradialytic hypertension, a study has found.
Stephen Padilla, 25 Jul 2019
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
25 Jul 2019
Adding a third drug to achieve the target blood pressure (BP) seems to be more effective than increasing the dose of existing dual therapy without any increase in adverse events, suggest the results of a meta-analysis, adding that early use of triple therapy can help improve hypertension control.